Tan Ru Yu, Allen John C, Kee Terence, Jafar Tazeen H
Department of Renal Medicine, Singapore General Hospital, Singapore.
Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore.
Nephrology (Carlton). 2017 Oct;22(10):761-768. doi: 10.1111/nep.12845.
Post-donation kidney function has not been well characterized in the Southeast Asian population. We studied a retrospective cohort of 174 living kidney donors at Singapore General Hospital between 1976 and 2012, evaluated patterns of change in kidney function using quantile regression analysis and investigated for predictors of low estimated glomerular filtration rate (eGFR) < 60 mL/min per 1.73m . Median follow-up time (range) was 7.8 (0.1-33.8) years following donor nephrectomy.
Of the donors, 43.1% regained 75% or more of pre-nephrectomy eGFR after 5 years post-donation; 9.8% exhibited 100% recovery to pre-nephrectomy eGFR. High pre-nephrectomy eGFR was protective for risk of low post-donation eGFR, with a 6% risk reduction for each unit increase in pre-nephrectomy eGFR (odds ratio, 0.94; 95% confidence interval, 0.91-0.97; P = 0.002). This relationship was stronger in the short term (>6 months to < 5 years) than medium to long term (5 years or longer) (interaction P = 0.052).
In general, kidney function is well preserved following kidney donation in Southeast Asian donors. Pre-nephrectomy eGFR is a good predictor of post-donation eGFR, especially in the short-term.
东南亚人群活体肾捐献后的肾功能情况尚未得到充分描述。我们对1976年至2012年间新加坡总医院的174例活体肾捐献者进行了一项回顾性队列研究，使用分位数回归分析评估肾功能变化模式，并调查估计肾小球滤过率（eGFR）<60ml/（min·1.73m²）的预测因素。肾切除术后的中位随访时间（范围）为7.8（0.1 - 33.8）年。
在这些捐献者中，43.1%在捐献后5年恢复到肾切除术前eGFR的75%或更多；9.8%的人eGFR完全恢复到肾切除术前水平。肾切除术前较高的eGFR对捐献后低eGFR风险具有保护作用，肾切除术前eGFR每增加一个单位，风险降低6%（优势比，0.94；95%置信区间，0.91 - 0.97；P = 0.002）。这种关系在短期内（>6个月至<5年）比中长期（5年或更长时间）更强（交互作用P = 0.052）。
总体而言，东南亚捐献者活体肾捐献后肾功能保存良好。肾切除术前的eGFR是捐献后eGFR的良好预测指标，尤其是在短期内。
